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25 June 2010, Volume 14 Issue 26 Previous Issue    Next Issue

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Design and construction of loading equipment suitable to manipulation for cell mechanics Ma Hui-sheng, Zhang Hong, Yan Jun-tao, Shen Guo-quan 2010, 14 (26):  4751-4754.  doi: 10.3969/j.issn.1673-8225.2010.026.001 Abstract ( 274 )   PDF (420KB) ( 404 )   Save BACKGROUND: Studies on the action mechanisms of manipulation mostly focus on the field in soft tissue, bone joint, nerve, and blood vessel. There are few reports on cytological level. OBJECTIVE: To design one kind of loading equipment suitable to manipulation for cell experiment in vitro to provide novel pathway and method for effective researches in cytological level. METHODS: Vascular endothelial cells distribution in vessel wall was simulated. Human umbilical vein endothelial cells (HUVECs) were planted into elastic cultivated tube which was regarded as model of blood vessel. Then elastic sponge materials with elasticity coefficient similar to muscle were used to simulate the tissues around the vessels and blood vessel models were placed in the simulated tissue. Rolling manipulation was operated on the surface to stimulate HUVECs to simulate in vivo mechanical environment to the largest extent. RESULTS AND CONCLUSION: A loading model for cell mechanics in vitro suitable to manipulation was established. The establishment of this model provides a new way to investigate the mechanism of manipulation action in the cytobiology. Related Articles | Metrics

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Application of digital plastic surgery in the treatment of jaw deformity Zhang Xiao-wei, Zhang Qi, Zhang Chun-guang, Jia Si-yuan, Chen Zu-xian, Ma Jing, Yang Yu-feng, Xu Peng, Yang Cheng, Gu Xiao-ming 2010, 14 (26):  4755-4759.  doi: 10.3969/j.issn.1673-8225.2010.26.002 Abstract ( 340 )   PDF (560KB) ( 600 )   Save BACKGROUND: Plenty of anatomic sites are involved in jaw deformity, which need to be repaired from solid structures. However, the treating outcomes are unsatisfactory due to lack of standardized surgery modes and the distinction of each patient.   OBJECTIVE: To explore the use of digital simulation skull model for designing and correcting asymmetrical deformity of jaws. METHODS: For a case with traumatic jaw deformity, CT scan and three-dimensional reconstruction were performed. Then rapid prototyping technique was used to produce the craniofacial skull model of the patient. In order to maintain the occluding relation, lower portion of maxilla and the whole mandible were counterclockwise rotated 5°, parts of sclerotin were removed from left mandible, and the mental region was left moved to the midline. Surgical procedures were simulated on the model and necessary supporting tools were prefabricated according to it, which also guided surgery and improved the accuracy of surgery. RESULTS AND CONCLUSION: The patient was satisfied with normal facial appearance, occlusion plane, and masticatory function after operation. The form of asymmetrical deformity of jaws can be truly reproduced by rapid prototyping and simulating operation process with the aid of digital plastic surgery, which provides strong basis for accurate diagnosis, reasonable surgical plans, and good result. Related Articles | Metrics

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Application of digital three-dimensional reconstructed titanium mesh to cranioplasty of large skull defect Peng Ya-bin, Mao Xiao-lin, Wang Xiao-feng, Yang Shu-zhen, Wang Jun, Chen Bo-bo 2010, 14 (26):  4760-4763.  doi: 10.3969/j.issn.1673-8225.2010.26.003 Abstract ( 292 )   PDF (418KB) ( 577 )   Save BACKGROUND: Digital three-dimensional reconstructed titanium mesh can best achieve physiologic and anatomical molding during large defect of skull in the frontotemporal area. OBJECTIVE: To compare the clinical effect of digital three-dimensional reconstructed titanium mesh and manual modeled titanium mesh for cranioplasty of defect of skull. METHODS: A total of 109 patients with skull defect were randomly assigned to two groups according to different methods: 60 patients with large skull defect were repaired with manual shaped titanium mesh, and 49 patients with digital three-dimensional reconstructed titanium mesh. Titanium mesh was made into individual skull prosthetic replacement by computer three-dimensional reconstruction. RESULTS AND CONCLUSION: The operation time, the incidence rate of complication and the degree of moulding satisfaction were 108 minutes, 22% and 67% in the manual modeled group, which were 78 minutes, 4% and 100% in the digital three-dimensional reconstructed group respectively. In the digital three-dimensional reconstructed group, the operation time was shorter and the incidence rate of complication was fewer, while the degree of moulding satisfaction was significantly higher than the manual modeled group (P < 0.05). Results have shown that digital three-dimensional reconstructed titanium mesh can save surgical duration, with less postoperative complications and have high satisfaction in cranioplasty Related Articles | Metrics

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Fast image segmentation and animation creating algorithms of talus based on Matlab Dai Hong, Yang Yun-feng 2010, 14 (26):  4764-4769.  doi: 10.3969/j.issn.1673-8225.2010.26.004 Abstract ( 857 )   PDF (553KB) ( 899 )   Save BACKGROUND: Orthopedic navigation uses the computer and machine vision technology, enables physicians to complete bone surgery under the guidance of computer screen. For subsequent localization work, first of all the lower limb bones must be segmented, 3D reconstructed and shown by animation based on the CT image sequence, and its position and orientation are measured. OBJECTIVE: To implement talus image segmentation, 3D visualization and generate its animation automatically on the computer, and to build a computer display platform for a new type of navigation system foot surgery. METHODS: The following Algorithms are proposed and realized by Matlab programming based on a CT image series of foot: ① Foot bone images are segmented by a threshold method based on the principle of maximum entropy to obtain foot skeleton. ②The talus is quickly and automatically segmented by a morphological method combined with Live-wire algorithm from the foot bone images. ③The three dimensional surface of talus is constructed using Marching Cubes method. ④A rotated animation of the talus is created and displayed by graphical functions of Matlab. RESULTS AND CONCLUSION: Results have shown that the proposed algorithms quickly and accurately realized the three-dimensional visualization of talus on common personal computer and can be applied in computer display platform of foot surgery navigation system. Related Articles | Metrics

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Biomechanical changes in individualized metacarpophalangeal joint titanium alloy prosthesis Wang Peng, Xuan Zhao-peng,Zhao Cheng-bin, Zhang Jun, Qian Gui-bin, Liu Can, Lu Lai-jin 2010, 14 (26):  4770-4773.  doi: 10.3969/j.issn.1673-8225.2010.26.005 Abstract ( 288 )   PDF (407KB) ( 419 )   Save BACKGROUND: Studies have been conducted regarding biomechanics of non-individualized prosthesis. But biomechanical data of individualized metacarpophalangeal (MP) joint prosthesis are few. OBJECTIVE: To explore the superiority of biomechanical characters to detect biomechanics of individualized prosthesis. METHODS: The experimental specimens were divided into three groups. Individualized prosthesis group (MP joints were replaced by individualized titanium alloy prosthesis), control group (MP joints were replaced by Swanson prosthesis) and normal group (normal human hand). Every group was subjected to vertical loading of 50, 100, 150, 200, 250, 300, and 350 N by CSS-44020 machine. The strain changes of metacarpal and phalanx bone were observed and the loading-strain curves were drawn. The biomechanics of individualized Titanium alloy prosthesis, Swanson prosthesis and normal MP joints were analyzed and compared. RESULTS AND CONCLUSION: The strain of metacarpal and proximal phalanx bones was increased with increasing loadings. The strain of each test displayed normal distribution. The strain changes of metacarpal bones were greater than proximal phalanx bones at different loading. They all had “platform” period at 300-350 N. No significant strain changes were observed in each group under 50 N loading. The straining changes of control group were significantly different from the other groups when the loading was larger than 100 N. But no differences were observed between individualized prosthesis and normal groups. Results show that individualized titanium alloy prosthesis well matched anatomy of MP joint, and displayed better biomechanics compared with Swanson prosthesis. It provides a novel ideal MP joint for clinical application. Related Articles | Metrics

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Local injection of bupivacaine following total knee arthroplasty: Analgesia effect and safety evaluation Man Zhen-tao, Li Wei, Zhang Wei, Sun Shui, Wang Jian, Wang Xian-quan, Li Bin 2010, 14 (26):  4774-4777.  doi: 10.3969/j.issn.1673-8225.2010.26.006 Abstract ( 287 )   PDF (354KB) ( 494 )   Save BACKGROUND: To ease the pain after total knee arthroplasty (TKA), intravenous catheter analgesia pumps, oral or intravenous pain medications are clinically used currently, which can reduce the pain of patients to some extent. However, intravenous analgesia pump and oral drugs have many side effects, such as affecting the functional exercise patients after the operation and increasing the incidence of complications. OBJECTIVE: To investigate the efficacy and security of the local application of bupivacaine for pain after TKA. METHODS: From November 1st, 2008 to December 31st, 2009, 168 patients (218 knees) undergoing TKA were selected from Department of Joint Surgery, Provincial Hospital Affiliated to Shandong University. Patients of the intervention group were injected with opite drugs (0.75%bupivacaine 10 mL+epinephrine 0.1 mg+saline 20 mL) in the surgical field around the knee. The control group did not use the anesthesia drug in the local area. Both groups used the intravenous analgesia pump for 50 hours. Visual analog scores and hospital for special surgery knee score for pain were recorded. RESULTS AND CONCLUSION: Patients in the control group had higher visual analog scores for pain at rest and activity at hours 4, 8 and 12 postoperatively compared with the intervention group (P < 0.05). Three months after TKA, no significant difference was found for special surgery knee scores for pain between two groups (P > 0.05). Four patients in the intervention group took the tramadol sustained-release tablets after the operation, while there were eleven in the control group; sixteen patients in the intervention group could endure the pain with intravenous catheter analgesia pumps only, but only 9 patients in the control group (P < 0.05). In conclusion, intraoperative periarticular injection of bupivacaine in TKA can reduce the pain and improve range of motion at early time, but the injection had no adverse effect on TKA in a short term period. Related Articles | Metrics

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Correlation between urinary EKGPDP peptide level and cartilage degradation in knee osteoarthritis patients following knee replacement or arthroscopic debridement Lin Qi-sheng, Xiao De-ming, Peng Jian-qiang, Cai Han-zhou, Ma Shu-qiang, Wu Wei-dong 2010, 14 (26):  4778-4782.  doi: 10.3969/j.issn.1673-8225.2010.26.007 Abstract ( 365 )   PDF (453KB) ( 334 )   Save BACKGROUND: Current approaches for diagnosis of osteoarthritis include imaging and arthroscopy. However, both of them have some limitations. Therefore, a specific, sensitive, high diagnostic rate and operable method is needed. OBJECTIVE: To explore the relationship between the level of EKGPDP peptide in urine and the severity of cartilage degradation in knee osteoarthritis patients.  METHODS: A total of 60 patients with knee osteoarthritis (KOA), including 45 undergoing joint debridement and 15 undergoing knee replacement, were selected from Department of Orthopaedics, Fourth People’s Hospital of Shenzhen (Futian Hospital, Guangdong Medical University) between January 2006 and April 2008. In addition, 40 healthy volunteers were selected as controls. The EKGPDP peptide concentration in urine was measured with competitive enzyme-linked immunoassay (ELISA). The pathologies of the synovium and cartilage in knee osteoarthritis were observed with arthroscopy; the degree of synovitis and cartilage degradation under arthroscopy was graded with Ayral’s score system and Outbridge’s score system, respectively. RESULTS AND CONCLUSION: EKGPDP peptide level in KOA was greater than control group (P < 0.001). The EKGPDP peptide level in KOA was correlated positively with Outbridge’s score and body mass index (P < 0.001), but had no correlation with accumulative Ayral’s score (P > 0.05). Half a year after total knee replacement, the level of EKGPDP peptide decreased significantly (P < 0.05); arthroscopic debridement remained unchanged (P > 0.05). The EKGPDP peptide level in urine can reflect the degree of cartilage degradation, and it is a sensitive marker for the diagnosis of KOA. Related Articles | Metrics

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Non-cemented primary total hip arthroplasty in the aged patients: A 2-year follow-up Liu Zhi-li, Shu Yong, Tang Wen 2010, 14 (26):  4783-4786.  doi: 10.3969/j.issn.1673-8225.2010.26.008 Abstract ( 368 )   PDF (399KB) ( 355 )   Save BACKGROUND: Non-cemented prosthesis is commonly considered applicable for patients < 65 years, and cemented prosthesis for elderly patients with poor bone condition. However, there is no evidence that non-cemented prosthesis cannot be used for patients aged > 70 years, who are healthy, able to do daily activity, with no osteoporosis or with mild osteoporosis. OBJECTIVE: To evaluate the clinical effect of premiere non-cemented total hip arthroplasty in elderly patients. METHODS: A total of 57 cases (65 hips) of elderly patients, aged > 70 years, with an average age of 86.3 years, underwent primary total hip arthroplasty with non-cemented prosthesis, including 33 cases (33 hips) of femoral neck fractures, 18 cases  (25 hips) of femoral head avascular necrosis, and 6 cases (7 hips) of developmental dysplasia of hip. The operation time, blood loss, hospitalization time, beginning time of getting out of bed postoperation, Harris score, X-ray result, complications in 3, 6, 12 and 24 months postoperatively. RESULTS AND CONCLUSION: The follow-up time ranged from 6 to 40 months postoperation, with an average time of 19.6 months. A total of 53 patients were followed up and 4 cases were lost after 1 year postoperatively. No prosthesis loosening was observed, and no cases required reoperation. Harris score was increased from average 40.7±18.9 preoperatively to 89.2 ±5.5 postoperatively, with an excellent and good rate of 93.7%. Wound hematoma, cerebral vascular accident and urinary tract infection were respectively observed in 1 case. Elderly patients treated with non-cemented prosthesis in primary total hip arthroplasty obtained satisfactory short-term clinical outcomes. Related Articles | Metrics

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Huoxue Tongluo decoction in the prevention of lower extremity deep venous thrombosis following femoral head prosthetic replacement in the elderly patients Jin Xiang, Zhang Yun-shen, Chen Jin-fei, Ma Yong, Wang Pei-min, Dai Qing-sheng, Shen Ji-rong, Xu Jian-an 2010, 14 (26):  4787-4790.  doi: 10.3969/j.issn.1673-8225.2010.26.009 Abstract ( 270 )   PDF (313KB) ( 352 )   Save BACKGROUND: Artificial femoral head replacement has been commonly used in femoral intertrochanteric fracture in elderly patients. However, the incidence of postoperative deep vein thrombosis is high, especially prevalent in the lower extremities. Therefore, how to prevent and treat lower extremity deep venous thrombosis effectively has become a hot issue in the medical profession. OBJECTIVE: To observe the effect of Huoxue Tongluo decoction on deep vein thrombosis following operation of comminuted femoral intertrochanteric fracture in elderly patients. METHODS: A total of 38 elderly patients with comminuted femoral intertrochanteric fracture undergoing artificial femoral head replacement were randomly divided into two groups: Huoxue Tongluo decoction and low molecular weight heparin (LMWH) groups, which was respectively treated with Huoxue Tongluo decoction and subcutaneous injection of LMWH. Incision drainage volume, change of platelet count and prothrombin time of the patients in two groups were observed and compared. Deep vein thrombosis was examined with lower extremity vascular color Doppler. RESULTS AND CONCLUSION: Incision drainage volume of Huoxue Tongluo decoction was less than the LMWH group (P < 0.05), but no differences were observed in platelet count between two groups (P > 0.05). Huoxue Tongluo decoction and LMWH significantly extended prothrombin time and partial thromboplastin time, but effect of LMWH was better than Huoxue Tongluo decoction (P < 0.05). There were both two cases of mild deep venous thrombosis in two groups, and Huoxue Tongluo decoction and LMWH played similar role in the prevention of deep venous thrombosis. Results show that Huoxue Tongluo decoction can prevent the occurance of lower extremity deep venous thrombosis after operation of comminuted femoral intertrochanteric fracture in elderly patients, and its efficacy is similar as LMWH. Moreover, it has good safety, and can be widely used in the clinic. Related Articles | Metrics

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Zoledronic acid and pamidronate disodium for treating malignant bone metastasis pain: A Meta-analysis of effectiveness and safety Wang Kai, Wang Shuan-ke, Zhao Bin, Wang Na 2010, 14 (26):  4791-4795.  doi: 10.3969/j.issn.1673-8225.2010.26.010 Abstract ( 531 )   PDF (351KB) ( 663 )   Save BACKGROUND: Bone metastasis is a major reason for tumorous pain. The third generation of diphosphonate zoledronic acid and the second generation of pamidronate disodium display several clinical features in treating pain caused by bone metastasis, such as short administration, low dose and long effect. OBJECTIVE: To assess the effectiveness and safety of zoledronic acid compared with pamidronate disodium in treatment of pain caused by bone metastasis of malignance neoplasms. METHODS: A computer-based online search of Cochrane library, PubMed, EMBase, Chinese Biomedical Literature Database, China Journal Full-text Database, and Chinese Scientific Journal Full-text Database was performed. Randomized controlled trails (RCTs) on zoledronic acid and pamidronate in treatment of pain caused by bone metastasis of malignance neoplasms were identified. The methodological quality of the included studies was evaluated, and data analyses were performed using RevMan 5.0 software. RESULTS AND CONCLUSION: A total of 10 randomized controlled trials involving 2 731 patients were studied. Of the 10 trials, 7 were performed in China, and 3 in the United States. Evaluation of the methodological quality showed that the 10 RCTs had a moderate risk of bias. The result of Meta-analysis showed that there was no significant difference in the complete response rate (CR rate), partial response rate or total effective rate, (RR = 1.59, 95% CI: 0.91-2.80) (RR = 0.95, 95% CI: 0.81-1.12) (RR = 1.04, 95% CI: 0.97-1.12). Significant difference was noted in side effects but headache (RR = 0.82, 95% CI: 0.70-0.96). As to response rate and side effect, zoledronic acid was similar to pamidronate. Related Articles | Metrics

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Construction and spatial directions analysis of digitized visible model of frontal sinus drainage pathway Wang Xiao-lu, Shan Xi-zheng, Gao Jian-hua 2010, 14 (26):  4796-4800.  doi: 10.3969/j.issn.1673-8225.2010.26.011 Abstract ( 274 )   PDF (756KB) ( 590 )   Save BACKGROUND: Correct understanding of accessory nasal sinuses anatomic features is important for improving operative success and reducing complications. Two-dimensional CT images limit preoperative evaluation of frontal sinus cells and drainage pathway. OBJECTIVE: To develop the digitized visible model and to analyze the endoscopic space of the frontal sinus drainage pathway (FSDP) and related structures. METHODS: To create digitized visible model of the FSDP and related structures with the coronal CT data sets of a patient by AutoCAD (computer aided design), MOI (Moment of Inspiration) and SketchUp software package. The spatial relationship of the FSDP and related structures in the 0°rod-lens telescope with the 60° elevation angle (between the endoscope and bottom of nasal cavity) was simulated and observed. The images from the coronal CT were compared with the images of CT in the endoscope. The operation of the endoscope surgery was simulated.  RESULTS AND CONCLUSION: The digitized visible model of the FSDP and related structures for the endoscopic surgery was successfully reconstructed. The changes of visual spatial orientation were consistent with the perspective law. The drainage pathway and the spatial relationship of frontal sinus with related structures could be observed. The simulation of the endoscopic surgical process of the FSDP and related structures may be used for establishing the right visuospatial relationship. There were differences in the image of two dimensions, the solid of three dimensions and the visual field of the endoscope, which validated the perspective law in the visual space of the endoscope. The visuospatial concept of the endoscope was brought and emphasized. Digitized visible model provides the means to learn the endoscopic anatomy of the FSDP and can be used as teaching and simulating tool of surgical techniques. Related Articles | Metrics

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Motor cortex function localization based on cortical slow potential analysis Jiang Tao, Wu Xiao-ming, Ye Bing-gang 2010, 14 (26):  4801-4804.  doi: 10.3969/j.issn.1673-8225.2010.26.012 Abstract ( 323 )   PDF (389KB) ( 448 )   Save BACKGROUND: The cortical slow potential and its shift changes are present in all individuals. Based on slow cortical potentials and variation detection of neural cortex (motor area) brain mapping method can avoid the missed detection. Detailed studies on this aspect have been rarely reported. OBJECTIVE: To investigate the characteristics of principle and feasibility of cortical electroencephalogram (EEG) slow cortical potentials for the intraoperative neural cortex (motor area) function. METHODS: Brain cortex in the (motor) functional area of finger cortical areas of the cortex EEG data from 3 patients of Harbour Hospital was collected, and the corresponding finger bending motion data were collected as self-control. Wavelet decomposition and reconstruction of signals, extraction of sports event-related slow cortical potentials before and after the incident in the movement of energy (ERP indicators) as the characteristic parameter were performed, followed by construction of a particular threshold to classify. The outcome data were compared with the corresponding movement in bending finger, and the rate of correct detection was determined. The pilot data collected were divided into training and test groups, respectively for feature selection algorithms based classifier design and performance analysis. RESULTS AND CONCLUSION: With a slow cortical potential target as the characteristic ERP signal volume and 1.6 as the threshold for classification, the correct detection rate of classification and positioning was 84%. Cortex (motor area) slow potential feature extraction and classification can be more effective for motor cortex localization with detection of high resolution, to avoid missed benefits. Related Articles | Metrics

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Event-related potential on the function of construction factor in Chinese processing Yu Liang, Liu Jun-fei, Geng Li-bo, Feng Shi-wen, Yang Yi-ming 2010, 14 (26):  4805-4808.  doi: 10.3969/j.issn.1673-8225.2010.26.013 Abstract ( 337 )   PDF (427KB) ( 354 )   Save BACKGROUND: In recent years, with the rise of construction grammar theory, the function of constuction factor in language processing attracts more and more attention. However, whether these construction views agree well with the true situation in human’s brain, in other words whether these theories have neurophysiological basis requires verification by experiments of neurolinguistics. OBJECTIVE: To explore the function of constuction factor in Chinese processing with event-related potential (ERP) measures. METHODS: A total of 18 Chinese college students aged 21-24 years, were selected. There were 176 sentences as stimulating materials which included two kinds of correct Chinese sentences and two kinds of corresponding wrong sentences. Each word/character was presented for 300 ms with 400 ms interval. And the interval between two sentences was 2 000 ms. Subjects were asked to read each sentences presented on the screen and to decide whether these sentences true or false. The subjects responded by pushing buttons with left hand for “yes” and right hand for “no”. The reaction time and accuracy were recorded. The brain electricity was recorded by American Neuroscan electric conduction evoked potential workstation. N400 was used as an index of implicit processing mechanism, and P600 was used as an index of explicit processing mechanism. RESULTS AND CONCLUSION: There were no differences in N400 at the end of these two kinds of sentences, but as for LPCs, different sentence structures elicited different LPCs. The average amplitude of complicated sentences was higher than that of simple sentences. Results show that in Chinese processing, construction factor plays a very important role at the later integrating process of different structure sentences. Different structures elicit different LPCs at the end of a sentence. The LPCs at the end of a sentence can be used as an index to judge construction mental reality. Related Articles | Metrics

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Application of a modified fast independent component analysis in fetal electrocardiogram extraction   Du Yan-qin, Huang Hua 2010, 14 (26):  4809-4811.  doi: 10.3969/j.issn.1673-8225.2010.26.014 Abstract ( 328 )   PDF (304KB) ( 315 )   Save BACKGROUND: Fetal electrocardiogram (FECG) is an objective index of the activities of fetal cardiac electrophysiology, but the obtained FECG is interferenced by maternal ECG. How to extract the FECG quickly and effectively has become an important research topic. OBJECTIVE: To separate FECG signal from the mother's ECG more rapidly and accurately by using improved fast (ICA) algorithm in order to achieve a more accurate FECG examination from fetal health purposes. METHORDS: Relaxation factor and the closeness measure function were added to fast ICA, the differences of speed and accuracy between the improved algorithm and the original ICA algorithm for rapid separation of the mother and FECG signal were observed. RESULTS AND CONCLUSION: The simulation shows that the modified fast ICA can extract FECG from the mixed-signal quickly and efficiently and maintain the other signal simultaneously. Related Articles | Metrics

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Foot sole pressure signal power spectra based on computer recognition: Gait analysis between Parkinson’s patients and controls Han Yang, Ma Zhan-hong, Zhou Ping 2010, 14 (26):  4812-4814.  doi: 10.3969/j.issn.1673-8225.2010.26.015 Abstract ( 415 )   PDF (307KB) ( 390 )   Save BACKGROUND: Gait of Parkinson’s disease (PD) is a research focus. However, few studies explored the gait features from the pressures of sole of foot.  OBJECTIVE: To compare extracted features from the foot-pressure signals in PD patients and control subjects and realize automatic recognition by computer, so as to extract the pattern of walking in PD and help explain the disturbed gait through signal processing. METHODS: Autoregressive (AR) model was applied to the analysis of foot-pressure based on Yule-Walker equation for the calculation of power spectra. In the comparison process, we also gave our own definition to Associated Discrete Index in order to measure the discrete degree at a same frequency. The data from three research groups: Ga, Ju and Si were analyzed. The database included 18, 25, 29 control subjects and 29, 29, 35 PD patients respectively. RESULTS AND CONCLUSION: In different framework, obvious difference between PD patient and control subject through t-test was observed in spectral line distribution, and density. Spectral line of PD patients was dense with similar appearance compared with normal controls. Related Articles | Metrics

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Effect of pole parameters on the performance of conduction field by simulation in Maxwell 2D Chen Zhong-zhong, Yuan Heng, Su Zhi-jian, Zheng Wei 2010, 14 (26):  4815-4817.  doi: 10.3969/j.issn.1673-8225.2010.26.016 Abstract ( 395 )   PDF (421KB) ( 333 )   Save BACKGROUND: The evenness and directivity of electric field are two important indexes in endocardial three-dimensional mapping technology. The factors that impact the indexes are electric poles and mediator. Therefore, analyzing the influence of the factors on the electricity field is significant. OBJECTIVE: To analyze the effects of poles size and distance on the performance of conduction field. METHODS: The influences of pole parameters were analyzed through simulation and experiment. In a singleness mediator, through alternating the pole parameters step by step, the field voltage was measured and then the evenness index and directivity index were calculated. RESULTS AND CONCLUSION: The results indicated that the evenness index and directivity index got perfect when the size and distance of poles become large. When the poles are as large as the size of measure area, the evenness index is 0.017, which can satisfy the accuracy. Related Articles | Metrics

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Four-dimensional computerized tomography reconstruction based on body volume change   Zhang Shu-xu, Yu Hui, Yang Jun, Zhou Ling-hong, Zhang Hai-nan, Lin Sheng-qu 2010, 14 (26):  4818-4822.  doi: 10.3969/j.issn.1673-8225.2010.26.017 Abstract ( 388 )   PDF (522KB) ( 546 )   Save BACKGROUND: There is no domestic four-dimensional computerized tomography (4D-CT). The import 4D-CT system requires respiratory signals during image collection, limiting the reconstruction in only several CT machine. In addition, respiration monitor device and 4D-CT reconstruction software cost high, limiting the wide application in China. OBJECTIVE: To overcome the shortcoming of present commercial 4D-CT reconstruction system and implement 4D-CT reconstruction based on multi-slices CT scanner. METHODS: A 4D-CT reconstruction software program (GTH4DIM V2.0) was developed by using VC++ and VTK software tools. The CT data of patient undergoing free breathing were acquired in Cine mode by a GE LightSpeed 16 CT scanner, with the Cine during time equal to the breathing period of the patient plus one second (about 4-6 seconds), and 8 to 15 slices CT images were acquired by a row CT detector in every Cine scan. The phase of each CT slice was determined according to the volume change rule of scanned thoracic cavity and lung tissue during respiration. RESULTS AND CONCLUSION: All of the CT data with the same phase, which were acquired in Cine mode, were resorted by GTH4DIM V2.0 into a same CT series, and several 3D-CT series with the different phases could be obtained. 3D reconstruction of the CT data was completed by using GTH4DIM V2.0 software. Compared with the unsorted CT data, the motion artifacts in the 3D reconstruction of sorted CT data were significantly reduced, and all of the resorted multi-phase CT series result in a 4D-CT, which reflected the characteristics of the periodical motion viscera contained within the abdominal and thoracic cavities. The results suggest that time-resolved 4D-CT reconstruction of periodical motion viscera could be implemented with any general multi-slice CT scanners based on the volume change rule of scanned thoracic cavity and lung tissue during respiration, and the process of the 4D-CT data acquisition and reconstruction were independent on the respiration monitoring system and not restricted to the hardware or software of the CT scanner. Therefore, it is a universal 4D-CT reconstruction method. Related Articles | Metrics

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Bias field correction of magnetic resonance imaging Zhou Zhen, Liu Chun-hong 2010, 14 (26):  4823-4826.  doi: 10.3969/j.issn.1673-8225.2010.26.018 Abstract ( 513 )   PDF (461KB) ( 489 )   Save BACKGROUND: Current magnetic resonance (MR) imaging has gray bias field, which affects digital processing of medical images, such as segmentation, registration, and quantization. Correction of this adverse space density changes is a necessary process before imaging analysis. OBJECTIVE: To propose a model independent correction method of complex image signal bias field based on image data. METHODS: Data were provided by the Department of Radiology, Fuxing Hospital of Capital Medical University, and collected by MR device (GE, USA). All MR images were provided by the volunteers (imaging visual field 250 mm×250 mm, matrix 256×256, slice thickness 1 mm). Based on entropy method and Mask method, MR image bias field was corrected.  RESULTS AND CONCLUSION: This method can correct MR image bias field accurately and effectively. These results provided a new method of MR image bias field correction for MR image analysis, which improved the image analysis accuracy and robustness. Related Articles | Metrics

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Quantitative detection of early emanel artificial caries on the smooth surface using optical coherence tomography   Li Yan-ni, Wang Guan-hua, Yao Hui, Meng Zhuo, Dai Xiao-hua, Liang Yu, Lian Xiao-li, Wan Mu-sen, Zhang Lin-pu, Shi Bo-ya, Yao Xiao-tian, Liu Tie-gen 2010, 14 (26):  4827-4830.  doi: 10.3969/j.issn.1673-8225.2010.26.019 Abstract ( 425 )   PDF (439KB) ( 459 )   Save BACKGROUND: Optical coherence tomography (OCT) is a noninvasive imaging modality with high resolution. It can produce depth-resolved images of tooth utilizing near-infrared light and quantitatively examine the caries by detecting the backscatter signals. OBJECTIVE: To explore the ability of imaging the early enamel caries on the smooth surface and the accuracy of quantifying the caries depths with OCT via the comparative study of OCT and polarized light microscope. METHODS: The early enamel caries model on the smooth surface was prepared through a pH cycling model with calf (< 6 years old) lower incisor as sample, and detected by an all fiber-based OCT and polarized light microscope. The images and caries depths from both methods were compared using ANOVA and Pearson correlation. RESULTS AND CONCLUSION: OCT could image the early enamel caries. The reflectivity within the demineralized subsurface enamel was markedly greater than the sound enamel in the OCT images. There were no differences in caries depths between OCT and polarized light microscope. OCT, which could accurately quantify the caries depths, may be used to evaluate the longitudinal progress of the early caries. There was no correlation between the lesion depth and demineralization time (P > 0.05). The altered depths between interior and exterior of the test region were calculated. The increased depths were correlated with the demineralization time (r = 0.954, P < 0.05). Results suggested the wide prospect of this nondestructive and high-resolution method on the research and clinical diagnosis of early caries. Related Articles | Metrics

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Brain activation distribution following passive finger movement: A blood oxygenation level dependent functional magnetic resonance imaging evaluation Chen Zhi-guang, Huang Sui-qiao, Liu Bo, Zhong Jing-lian, Ye Rui-xin, Xu Xiao-mao 2010, 14 (26):  4831-4835.  doi: 10.3969/j.issn.1673-8225.2010.26.020 Abstract ( 318 )   PDF (386KB) ( 344 )   Save BACKGROUND: Motor function in cerebral cortex functional mapping has been extensively explored, but the majority of previous studies utilized active exercise tasks, which result in various errors and limitations to subjects. Passive movement can solve the above problems, but it remains unclear whether passive movement can replace active movement for functional imaging. OBJECTIVE: By comparing the brain functional localization variance between active right-handed finger movement and passive finger movement, to explore the feasibility of passive movement replacing active movement to perform blood oxygenation level dependent functional MRI (BOLD-fMRI). METHODS: A total of 8 normal volunteers were selected for BOLD-fMRI with both passive and active finger movements using Philips Intera Gyroscan 1.5T superconducting MR scanner. The fMRI data format was transformed and postprocessed by SPM2, a brain functional analyzing tool. By comparing the results of brain activation area and mean imaging between the two tasks, and analyzing the data using t test in SPM2, the feasibility of substitution with passive finger movement was verified. In addition, on the basis of time-signal intensity dynamic curve output automatically by SPM2, the signal increasing rate percent (SIRP) and the scale difference of brain activation in the two tasks were computed and analyzed. RESULTS AND CONCLUSION: The rates of appearances of SM1 activation from the contra-lateral hemisphere were 100%, and SM1 activation volumes were not statistically significant in both two tasks. The appearances of SMA, PMC activation were close, and the SIRPs were not statistically significant. BOLD-fMRI imaging can be performed by passive finger movement to substitute active finger movement. Related Articles | Metrics

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Breast tumor differential diagnosis based on ultrasound image feature parameters analysis Jiang Ling, Luo Ying, Peng Yu-lan, Liu Qi 2010, 14 (26):  4836-4840.  doi: 10.3969/j.issn.1673-8225.2010.26.021 Abstract ( 393 )   PDF (523KB) ( 425 )   Save BACKGROUND: Ultrasound diagnosis is non-invasive, reproducible and suitable for identification of soft tissue characteristics, which are widely used in the auxiliary detection of breast cancer. However, due to the lack of quantitative criteria, the diagnosis has shown a higher false positive rate with greater subjectivity and uncertainty. The problem is unsolved for clinicians regarding how to improve the diagnostic accuracy and reduce unnecessary biopsies. OBJECTIVE: To detect breast tumors using ultrasound image feature parameters. METHODS: Using level set method, 100 breast tumors were segmented and computed with 10 feature parameters including elongation factor, compactness factor, circularity factor and 7 Hu moment parameters. RESULTS AND CONCLUSION: The scatter graph showed elongation, compactness and circularity points were not superposed but almost concentrated around the same area without good differential diagnosis, and then 7 Hu values were used to analyze local areas around tumors with support vector machine classification. Hu1 and Hu 2 exhibited better outcomes, the accuracy was 88% and 88%, sensitivity was 86% and 90%, specificity was 90% and 86%, positive predictive value was 89.58% and 86.54%, and the negative predictive value was 86.54% and 89.58%, respectively. It suggested that ultrasound image feature parameters analysis provides guidance to differential diagnosis of breast tumors. Related Articles | Metrics

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Imaging and histological features of intervertebral disc under injured vertebral body in Denis type B thoracolumbar burst fracture   Zhang Liang, Jin An-min, Gao Liang-bin, Li Jian, Zhang Zhi 2010, 14 (26):  4841-4844.  doi: 10.3969/j.issn.1673-8225.2010.26.022 Abstract ( 354 )   PDF (401KB) ( 410 )   Save BACKGROUND: Evaluation of vertebral disc under the vertebral body facilitates selection of treatments. Currently, studies of Denis type B fracture intervertebral disc appearance and function in vertebral burst fractures are few. OBJECTIVE: To observe the imaging and histological features of vertebral disc under the vertebral body of Denis type B thoracolumbar burst fracture, to further evaluate the effect of preserving the vertebral disc under the injured vertebral body. METHODS: A total of 18 cases with Denis type B thoracolumbar burst fracture underwent X-ray, CT, and MRI examination. The anterior and posterior margin of intervertebral height under the injured vertebral body were accessed and compared with the normal height of intervertebrae by X-ray. Oner classification was performed based on the outcome of MRI examination. The signal intensity of nucleus pulposus (NP), annulus fibrosus (AF) and cerebrospinal fluid (CSF) on T2WI in sagittal position was measured, respectively. The ratio of signal intensity for NP/CSF and AF/CSF was calculated. The tissue of interested and normal vertebral disc was collected and measured by hematoxylin-eosin staining and alcian blue staining (absorbance value). The outcomes of staining were measured by Norbert Boos score. RESULTS AND CONCLUSION: The anterior and posterior margin of intervertebral height under the injured vertebral body was not significantly different compared with the normal intervertebrae by X-ray (P > 0.05). According to Oner classification, all the vertebral discs under the injured vertebral body of 18 cases were in type Ⅰ, i.e., the vertebral disc was normal or near-normal, and there were no vertebral disc of type Ⅱ - Ⅴ. The signal intensity ratio of AF/CSF, the signal intensity ratio of NF/CSF for the vertebral disc under the injured vertebral body displayed no significant differences compared with the normal ratio of NF/CSF (P > 0.05). Norbert Boos histological score and the absorbance values of alcian blue staining of the interested vertebral disc were similar to the normal one (P > 0.05). The vertebral disc under the injured vertebral body remained no obvious damage, and the structure was examined by X-ray, CT, and MR. Histological analysis shows that the vertebral disc could be preserved. Related Articles | Metrics

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Total knee replacement for 98 knees of 86 gonarthrosis patients Wang Liang, Zhen Xiang-zhou, Guo Qian-jin, Yang Yan-ting 2010, 14 (26):  4845-4847.  doi: 10.3969/j.issn.1673-8225.2010.26.023 Abstract ( 264 )   PDF (327KB) ( 333 )   Save BACKGROUND: The total knee arthroplasty is an effective method to treat the gonarthrosis, but the curative effect is related with many factors. OBJECTIVE: To explore the result for the treatment of gonarthrosis with total knee arthroplasty. METHODS: From July 1999 to June 2008, the total knee arthroplasty was performed in 86 gonarthrosis patients (98 knees), no whirbone was replaced. A total of 95 knees in 84 cases were treated with posterior stabilized total knee prosthesis, including 92 knees prosthesis from Plus company and 3 posterior stabilized prosthesis from U.S. Stryker; one case used posterior cruciate ligament prosthesis (BCAE, Beijing, China) in both knees, and one case used Aikang prosthesis in one knee. Patients were regularly followed up after replacement, and knee joint function was evaluated using U.S. John.N.Insall scoring system. RESULTS: The average follow-up time in 86 cases was 5.2 years (range 1-9 years). To the last visit of follow-up, the knee joints flexion was less than 90° in 5 cases of 7 knees and extension was more than -10° in 2 cases. Among these cases, 1 case of 2 knees was rheumarthritis patient, 1 case of 2 knees used domestic implant of knee joint in early time. One case exhibited repeated joint effusion within one year after operation, and was cured by conservative treatment, but the knee joint activity was lost. According to John.N.Insall scale, the excellent and good rate was 90.7%. It was improved distinctly in ache degree, joint function and activity after total knee arthroplasty. It is suggested that total knee arthroplasty is an effective method of treating gonarthrosis. It can acquire satisfactory effect with strict choice of surgical indication, standard surgical operation and systematic recovery training. Related Articles | Metrics

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Minimally invasive total hip arthroplasty versus standard total hip arthroplasty in 30 cases Chen Kai, Liang Wen-qing, Li Jian, Cai Zheng-dong, Hua Ying-qi, Zheng Long-po 2010, 14 (26):  4848-4851.  doi: 10.3969/j.issn.1673-8225.2010.26.024 Abstract ( 376 )   PDF (387KB) ( 331 )   Save BACKGROUND: Minimally invasive hip replacement has been utilized in some hospitals. However, the incision size and location are different. OBJECTIVE: To compare the surgical experience and clinical outcome between minimally invasive total hip arthroplasty (THA) and conventional THA. METHODS: A total of 30 cases (30 hips) underwent THA through a minimal incision posterolateral surgical approach (MIS group) and another 30 cases received THA through a standard posterolateral approach at the same period (standard group). The age, gender and body mass index between two groups were similar (P > 0.05), and their disease spectrum was similar. They were treated by cementless prosthesis (Smith &Nephew Company). The operation time, blood loss, incision length, functional recovery, and prosthetic position were analyzed and compared between the two groups. RESULTS AND CONCLUSION: There were significant differences in average incision length, amount of bleeding, postoperative drainage and transfusion between two groups (P < 0.05), and the MIS group was superior to the standard group. There were no significant differences in operation time, postoperative imaging evaluation and acetabular angle between two groups (P > 0.05). Functional recovery of MIS group was rapid than standard group at the early stage, but the functions of joint were similar in middle-stage in both groups. Follow-up period after operation, the prosthesis position was good both in MIS and standard groups. There was no complication in MIS group with the exception of skin abrasin in two cases. The advantages of MIS THA are less traumatic blood loss, good cosmetic incision and rapid recovery of function. The MIS THA can only be used by surgeons rich in experience in THA and in hospitals provided with necessary instruments. Related Articles | Metrics

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Evaluation of flexion-extension motion of knee joints prior to and after “female knee” replacement in 11 cases Wang Xi-bin, Sun Yong-qiang 2010, 14 (26):  4852-4855.  doi: 10.3969/j.issn.1673-8225.2010.26.025 Abstract ( 284 )   PDF (383KB) ( 417 )   Save BACKGROUND: Most of knee replacement prosthesis is designed for male, which differs from female in physiological and anatomical characteristics. Clinical anatomy showed that, the shape of knee joints has great differences between males and females, especially in patellofemoral joint. Accordingly, compared with males, the complications in females following knee replacement are greater. OBJECTIVE: To observe the function and range of motion of knee joint after “female knee” replacement, and to analyze the design features of “female knee” in dealing with patellofemoral joint. METHODS: Totally 11 (13 knees) female cases who suffered from knee osteoarthritis and were treated by “female knee” replacement (Jianda, Zimmer Cooperation, USA) were selected. The ages of cases were 61-81 yearsold, and 2 cases suffered form both knee osteoarthritis. All knees had flexion or inversion deformity. The function and range of motion of knee joints were compared before and after “female knee” replacement. The hospital for special surgery (HSS) knee rating scale was used to evaluate knee functions. The full score of HSS was 100, over 85 were excellent, 70-84 were good, 60-69 were fair and lower than 60 were poor.  RESULTS AND CONCLUSION: Compared with before replacement, the HSS scores of knee joints were increased (P < 0.01), and the range of motion was greater in all cases at 12 weeks after replacement (P < 0.01). The strength and stability of knee were increased, which could meet the needs of daily life and increase living standard of patients. Results demonstrated that the design of “female knee” is identical to anatomical characteristics of Arian females, which can achieve good therapeutic effects in clinical application. Related Articles | Metrics

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Elderly hip replacement and isobaric spinal anesthesia in combination with lumbar plexus anesthesia  Song Hai-ming, Du Ning 2010, 14 (26):  4858-4861.  doi: 10.3969/j.issn.1673-8225.2010.26.027 Abstract ( 298 )   PDF (457KB) ( 316 )   Save OBJECTIVE: To explore isobaric spinal anesthesia in combination with lumbar plexus anesthesia in application of elderly hip joint surgery. METHODS: With lumbar anesthesia, hip replacement as Chinese key words, articles published between January 2000 and March 2010 were searched. Articles related with lumbar anesthesia, hip replacement were included. Repetitive studies were excluded. Finally, 11 articles were discussed, and 50 patients selectively undergoing hip replacement were selected as clinical validation. Using isobaric spinal anesthesia in combination with lumbar plexus anesthesia, the patients were maintained in lateral position. Hemodynamics and heart rate changes before, and 5, 15, 30 minutes after anesthesia were observed. Bilateral algesia blocking plane, temperature sense and touch sensation, Bromage motor blocking score, adverse effects, effective analgesia time and effective blocking time of affected limbs were investigated. RESULTS: Currently used anesthesia methods for the elderly hip replacement include ropivacaine lateral combined spinal epidural anesthesia, levobupivacaine in combination with sufentanil combined spinal epidural anesthesia, continuous epidural anesthesia in combination with low-dose bupivacaine lumbar anesthesia. Studies have shown that combined anesthesia displays better than medication alone. Clinical results show that hemodynamics and heart rate remained unchanged following isobaric spinal anesthesia in combination with lumbar plexus anesthesia. Algesia blocking plane, temperature sense and touch sensation, Bromage motor blocking score of lesioned side displayed significant differences compared with normal side (P < 0.01). In addition, 1 case developed vomiting and 6 hypotension. The effective analgesia time and effective blocking time of affected limbs were (5.5±2.2) hours and (2.5±0.5) hours were investigated. CONCLUSION: Isobaric spinal anesthesia in combination with lumbar plexus anesthesia is safe and reliable in elderly hip replacement with little physiological interference. Related Articles | Metrics

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Biomechanical analysis following femoral prosthesis implantation Xiao Wan-guo 2010, 14 (26):  4862-4865.  doi: 10.3969/j.issn.1673-8225.2010.26.028 Abstract ( 260 )   PDF (446KB) ( 374 )   Save OBJECTIVE: To explore biomechanics following femoral prosthesis implantation. METHODS: A computer-based online search of PubMed and CNKI databases was performed with key words “biomechanics, femoral prosthesis” in English and Chinese. Articles related to biomechanics following femoral prosthesis implantation, published recently in authoritative journals of the same domain were selected. Finally, 26 articles were included. RESULTS: Bone repair materials commonly used included autologous bone and metal prosthesis. Autologous bone is ideal repair materials, but bone acquisition increases trauma and pain for patients, and the source is greatly limited. Metal prosthesis is sensitive to wound, with some disadvantages, such as loosening, breakage, poor histocompatibility, and nondegradable. CONCLUSION: Orthopedic implants application has resolved problems in orthopedic field. Ideal artificial bone substitutes for bone defects are important for medical and tissue engineering fields. Related Articles | Metrics

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Femoral head prosthesis replacement and femur intertrochanteric comminuted fracture  Zheng Hai, Li Yi, Guo Yan-long 2010, 14 (26):  4866-4869.  doi: 10.3969/j.issn.1673-8225.2010.26.029 Abstract ( 282 )   PDF (517KB) ( 257 )   Save OBJECTIVE: To summarize the classification and features of head prosthesis and to analyze its application in treating elderly femur intertrochanteric comminuted fractures. METHODS: Databases of PubMed and CNKI were searched by the first author using key words of “artificial femoral head prosthetic, replace, elderly patients, femur intertrochanteric comminuted fracture” both in English and Chinese. Documents published recently or in authoritative journals were preferred. A total of 29 papers were included in this paper. RESULTS: Femoral head prosthesis had been widely used in treating femur intertrochanteric fractures. Many kinds of the femoral head prostheses, such as metal materials, macromolecular polyethylene, ceramics and carbonaceous materials have been applied in the clinic, and received good therapeutic effects. Femoral head prosthesis is one of the most effective methods for treating femur intertrochanteric comminuted fractures, but the problems including high operation risks and complications need to be solved. CONCLUSION: Plenty of materials are involved in preparing artificial femoral head prosthesis with unique advantages and drawbacks. The composite materials are preferred in the clinic. Femoral head prosthesis is an ideal method for treating elderly femur intertrochanteric comminuted fractures. Related Articles | Metrics

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Treatment effects of artificial femoral head replacement versus internal fixation on elderly intertrochanteric fractures Du Guang-yu, Zhao Wen-zhi, He Sheng-wei, Fang Xu, Mi Li-dong, Sun Chuan-xiu, Zhang Lu, Sun Xue-gang 2010, 14 (26):  4870-4873.  doi: 10.3969/j.issn.1673-8225.2010.26.030 Abstract ( 394 )   PDF (464KB) ( 462 )   Save OBJECTIVE: To compare artificial femoral head replacement and internal fixation in treating elderly intertrochanteric fractures, and explore the indications. METHODS: A computer-based online search was performed for articles published between January 1969 and October 2009 with the key words “hip replacement, intertrochanteric fractures, internal fixations” in English. Articles related with biomaterials and tissue engineered materials were included. Repetitive studies or Meta analysis were excluded. A total of 10 articles were discussed. A total of 168 patients, aged over 75 years, were selected from Department of Orthopedics, Second Hospital of Dalian Medical University and treated with artificial femoral head replacement and internal fixation. The operation time, bleeding, postoperative complications, bed stay duration, hip functional recovery, and hospitalization duration were compared. RESULTS: Elderly intertrochanteric fractures have been majorly treated by internal fixation. It remains controversial whether artificial femoral head replacement is necessary. Currently, artificial hip prosthesis materials include cobalt alloy and titanium alloy, polyethylene, porous polysulfones, acetal resinoid, and carbon. The internal fixation patterns include cement-typed prosthesis, biotype prosthesis, their combination, and modern cement technique. Clinical results show that artificial femoral head replacement displayed advantages in operation time, postoperative complications, bed stay duration, and hospitalization duration compared with internal fixation (P < 0.05). The hip functional recovery was superior to internal fixation at 1, 3, and 6 months postoperatively (P < 0.05), but no differences were observed at 12 months postoperatively (P > 0.05). CONCLUSION: Artificial femoral head replacement has advantages of early postoperative recovery, early weight loading and few complications in treating elderly intertrochanteric fractures compared with the internal fixation. However, the long-term complications require further observation. Related Articles | Metrics

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Application of external fixator to damage control treatment in rehabilitation of orthopedic trauma  Lu Hai-jiang, Zhen Wan-xin 2010, 14 (26):  4874-4877.  doi: 10.3969/j.issn.1673-8225.2010.26.031 Abstract ( 493 )   PDF (430KB) ( 449 )   Save BACKGROUND: Serious patients with severe multiple fractures or comminuted fractures with multiple trauma cannot bear complex and extensive operation. For these patients, application of external fixator to damage control surgery treatment in rehabilitation of orthopedic trauma has been gradually performed in clinical practice. OBJECTIVE: To summarize necessities, indications, procedures, merits and effects of using external fixator to damage control surgery treatment in rehabilitation of orthopedic trauma by reviewing and analyzing lots of literatures. METHODS: A computer-based online research of PubMed (1990/2009-12) and CNKI (1995/2009-12) was performed with key words of “damage control, external fixator, fracture, trauma, rehabilitation”. The literature was limited to English and Chinese languages. Literatures concerning application of external fixator to damage control surgery treatment in rehabilitation of orthopedic trauma were included, including reviews and clinical experiments. Animal experiments, duplicated study and contents inconsistent with the research purpose were excluded. RESULTS AND CONCLUSION: A total of 289 articles were initially searched by computer, according to inclusive and exclusive criteria, 130 unrelated articles were excluded, and those published in the last 10 years were selected from the remainder 159 articles. Finally 25 literatures were included. Based on literature review, the reasonable application of external fixator to damage control surgery treatment in rehabilitation of orthopedic trauma improves the survival rate of serious patients with severe multiple fractures or comminuted fractures with multiple trauma, and proves to be clinically effective and secure. Related Articles | Metrics

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Application and biocompatibility of pedicle screws in thoracolumbar fracture internal fixation Xiao Xu-yang, Wang Xiao-dong, Zang Dong-yu 2010, 14 (26):  4878-4881.  doi: 10.3969/j.issn.1673-8225.2010.26.032 Abstract ( 383 )   PDF (426KB) ( 394 )   Save OBJECTIVE: To discuss application of pedicle screws in thoracolumbar fractures internal fixation and evaluate the biocompatibility. METHODS: A computer-based online search of PubMed database (1989/2009) and CNKI (1989/2009) was performed with key words “pedicle screws, thoracolumbar, fractures, biocompatibility” in English and Chinese. A total of 57 articles were collected, and 31 were included according to inclusion and exclusion criteria. RESULTS: Posterior pedicle screw internal fixation system is an effective tool for thoracolumbar fractures. However, the screw breakage frequently occurs. Pedicle screw internal fixation in combination with autologous bone or artificial materials in cavity of lesioned vertebra effectively reduces implant loosening, breakage, but the cost is high. Full bone implants in internal fixation and withdrawal following fracture healing can effectively prevent spinal fixator breakage. Pedicle screws of stainless steel have great intensity, but poor histocompatibility. The biocompatibility of titanium materials for internal fixation is good, but their rigidity is small. CONCLUSION: Pedicle screw internal fixation system is an effective method for thoracolumbar fractures. The biocompatibility of various pedicle screws requires improvement. For example, the biocompatibility of titanium materials for internal fixation is good, but their rigidity is poor, while the stainless steel has great intensity, but poor histocompatibility. Related Articles | Metrics

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Identification and operation skills of “pain-free rehabilitation” program He Hong-chen, Xiong En-fu 2010, 14 (26):  4882-4884.  doi: 10.3969/j.issn.1673-8225.2010.26.033 Abstract ( 356 )   PDF (339KB) ( 324 )   Save OBJECTIVE: To explore identification and operation skills of “pain-free” rehabilitation therapy. METHODS: Pain affects normal daily life, work and study. Rehabilitation therapy with pain aggravates patient pain. Therefore, it is important to adopt a “pain-free” treatment program and prevent the onset of this type of pain. To achieve a clear definition of “pain-free rehabilitation” and use of an appropriate indicator for the pain threshold of “pain-free rehabilitation“ is required. RESULTS: Monitor of pain stress response during treatment attenuated pain, reduced treatment injury while maintaining the treatment efficacy. CONCLUSION: From painful rehabilitation treatment to “pain-free rehabilitation”, it has been shown that “pain-free rehabilitation”  improves function and prevents treatment injury. This demonstrates feasibility of pain-free rehabilitation. Related Articles | Metrics

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Relationship between endothelin-1 level changes and intravascular restenosis following cardiovascular stent implantation Bu Huang 2010, 14 (26):  4885-4888.  doi: 10.3969/j.issn.1673-8225.2010.26.034 Abstract ( 326 )   PDF (545KB) ( 353 )   Save OBJECTIVE: To explore relationship between host endothelin-1 level changes and intravascular restenosis during and after heart stent implantation. METHODS: A computer-based online search of VIP database was performed for articles published between January 1994 and October 2009, with key words “stent implantation, restenosis, endothelin-1, drug-eluting stent” in Chinese. A total of 22 articles were analyzed. RESULTS: Endothelin-1 is the endogenous vasoconstriction peptide with strong and continuous effect. It plays an important role in general blood pressure, local blood flow perfusion, promotion of mitosis and cell proliferation. Restenosis following percutaneous tranluminal coronary angioplasty is a process of endothelium dysfunction. Under normal condition, endothelial cells-released growth factor maintains a dynamic balance with growth inhibiting factor. However, this balance is damaged by percutaneous tranluminal coronary angioplasty, resulting growth stimulating factor activation, leading to vascular smooth muscle cell proliferation, migration and promoting restenosis formation. CONCLUSION: Drug-eluting stent effectively inhibits host endothelin-1 increase, which may contribute to the prevention of restenosis. Related Articles | Metrics

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Locking compression plate versus anatomical plate for intertrochanteric fractures in 107 cases Dou Yong-feng, Meng Tao, Wang Zhi-gang, Geng Xiao-peng, Zhang Kai, Li Xian-rang 2010, 14 (26):  4889-4893.  doi: 10.3969/j.issn.1673-8225.2010.26.035 Abstract ( 332 )   PDF (444KB) ( 441 )   Save BACKGROUND: The intertrochanteric fracture, in particular in the elderly, is the site of stress concentration. To seek a firm fixation and minimally invasive way has been the efforts by orthopedic associates. In recent years, anatomical plate has been reported to be used for intertrochanteric fractures, but the locking compression plate has been reported rarely. OBJECTIVE: To investigate the efficacy between locking compression plate (LCP) and anatomical plate for the treatment of intertrochanteric fracture. METHODS: From March 2005 to June 2008, 107 cases of intertrochanteric fracture of femur were treated with anatomical plate or LCP, including 62 cases with anatomical plate and 45 with LCP. Anatomical plate, stainless steel, was purchased from Link, Germany; LCP, titanium alloy, was purchased from Weigao Orthopedic Materials, China. The operation parameters and follow-up results following fixation using two methods were compared RESULTS AND CONCLUSION: The patients of two groups were followed up from 6 months to 2 years, with the average time of 13 months. In anatomical plate group, there were loose screws, nails back and coxa vara in 7 cases, nonunion in 2 cases, deep vein thrombosis in 2 cases and postoperative wound infection in 1 case. In LCP group, there were mild coxa vara and malunion in 1 case and deep venous thrombosis in 1 case. The incidence of postoperative complications in LCP group was significantly lower than anatomical plate group (P < 0.05), and the excellent and good rate of hip function was significantly better than in the anatomical plate group (P < 0.05). Compared with anatomical plate for the treatment of intertrochanteric fracture, especially in elderly patients with osteoporosis, LCP displayed reliable effect and higher rate of fracture healing but less complications. Related Articles | Metrics

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Polyaxial locking plating for fractures of the distal tibia with very short metaphyseal fragments: Retrospective analysis of 32 cases from one institution in 1 year Gao Hong, Zhang Chang-qing, Luo Cong-feng, Zhou Zu-bin, Zeng Bing-fang 2010, 14 (26):  4894-4898.  doi: 10.3969/j.issn.1673-8225.2010.26.036 Abstract ( 354 )   PDF (586KB) ( 355 )   Save BACKGROUND: Minimally invasive plate osteosynthesis (MIPO) has become widely used for the treatment of complex fractures of the distal part of the tibia. For relatively small distal tibia fracture fragment, a monoaxial locking plate with fixed-trajectory locking screws sometimes may not provide anticipated fixation stability for the distal fragment. OBJECTIVE: To evaluate primary clinical outcomes of fractures of the distal tibia with very short metaphyseal fragments treated with polyaxial locking plating. METHODS: A total of 32 adult patients with very short metaphyseal fragments in fractures of the distal tibia were treated with a polyaxial locking plate. The average distance from the distal extent of the fracture to the tibial plafond was 11 mm. There were 9 cases of open fractures. All fractures involved the metaphyseal part of the distal tibia, and in 14 cases the fracture extended distally into the ankle. Of them, 21 patients were treated with MIPO, and 11 with traditional open reduction and internal fixation. The incision and complications were observed. The patients were followed up until fracture healing. The results were evaluated by AOFAS scores. RESULTS AND CONCLUSION: All fractures healed. The average time to union for all fractures was 14 weeks (range, 10–20 weeks). The average healing time for fractures using the MIPO technique was significantly shorter than traditional technique (P < 0.01). Closed fractures healed rapidly compared with open fractures (P < 0.05). Using the AOFAS ankle-hindfoot scale, the average functional score was 87.3 points (range, 72–98 points). All results demonstrated that the polyaxial locking plate offering more fixation versatility can provide a high degree of angular and axial stability to short articular segments and metaphyseal comminution, with low incidence of complications. Therefore, it can be considered a feasible and worthwhile method of stabilization and recommended for the treatment of these special type fractures of the distal tibia Related Articles | Metrics

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Antegrade intramedullary nailing versus retrograde intramedullary nailing for humeral shaft fracture in 18 cases Yin Biao, Yang Bo, Li Jian, Zhang Zhi, Zhang Liang, Song Lei, Wang Le, Qiu Qin-ye 2010, 14 (26):  4899-4902.  doi: 10.3969/j.issn.1673-8225.2010.26.037 Abstract ( 327 )   PDF (319KB) ( 352 )   Save BACKGROUND: Intramedullary nailing in treatment of humeral shaft fractures prevents plate implantation-induced stress shield or radial nerve injury, and accords with modern minimally invasive orthopedics. It has become a biological internal fixation method. OBJECTIVE: To compare the effectiveness between antegrade and retrograde intramedullary nailing for the treatment of humeral shaft fractures. METHODS: A total of 18 patients with humeral shaft fractures were treated with Russell-Taylor nail, including 10 antegrade nailing and 8 retrograde nailing. The shoulder function was evaluated using X-ray examination. RESULTS AND CONCLUSION: A total of 14 patients were followed-up for 8-15 months, including 8 of antegrade nailing and 6 of retrograde nailing. The shoulder function was excellent in 5 cases, good in 2 cases and fair in 1 case undergoing antegrade nailing; excellent in 5 and good in 1 undergoing retrograde nailing. Antegrade and retrograde nailing have similar treatment results, which reduce radial nerve injury, decrease trauma, and fix well. However, antegrade nailing can injury rotator cuff, and retrograde nailing may lead to bone breakage. Therefore, they may be good alternatives for the treatment of humeral shaft fractures according to the condition of patients. Related Articles | Metrics

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Combined external fixators in treatment of open fractures of tibia and fibula Zhang Cheng, Shao Hui-yong, Li Zong-ling 2010, 14 (26):  4903-4906.  doi: 10.3969/j.issn.1673-8225.2010.26.038 Abstract ( 226 )   PDF (421KB) ( 332 )   Save BACKGROUND: It is difficult to maintain fracture end stability or protect damaged blood transport in treating open fractures of tibia and fibula. Combined external fixators can early restore bone structures and attenuate soft tissue injury following fracture. OBJECTIVE: To observe the clinical efficacy of combined external fixators for open fractures of tibia and fibula. METHODS: A total of 28 cases of open fractures of tibia and fibula, including 22 males and 6 females, aged 23-61 years, were selected from People’s Hospital of Tianjin Wuqing District between March 2005 and December 2008. All patients were treated with the combined external fixator. The trauma healing and knee, ankle joint recovery, and complication were observed. The treatment effect was evaluated using Johner-Wruhs method. RESULTS AND CONCLUSION: The patients were followed-up for 8-24 months. There were 16 cases achieving bone healing in 4-6 months, 8 cases achieving bone healing in 8 months, and 4 cases within 12 months to achieve bone healing. No nonunion occurred, and limb functional recovery was satisfied. Johner-Wruhs evaluation was excellent in 18 cases and good in 10 cases. Results show that combined external fixators achieved an early fracture reduction, reliable fixation, early activities off the bed and reduced the incidence of complications of fractures in treating tibial and fibular open fractures. Related Articles | Metrics

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Internal fixation modes and materials of metal implants for displaced supination-eversion ankle fractures in elderly patients Li Jun, Chai Wei-bing, Lu Hong-zhang, Liu Zhen-ning, Liu Xian-yi, Zhu Tian-yue 2010, 14 (26):  4907-4910.  doi: 10.3969/j.issn.1673-8225.2010.26.039 Abstract ( 380 )   PDF (391KB) ( 351 )   Save BACKGROUND: Stable anatomical reconstruction of the joint surface in displaced supination-eversion ankle fractures is essential to successful recovery. It is difficult to fix the osteoporosis ankle fracture in the elderly patients, thus, complications often happen after open reduction and internal fixation. OBJECTIVE: To explore the surgical treatment internal fixation selection for displaced supination-eversion ankle fracture in elderly patients.  METHODS: Totally 128 elderly patients with supination-eversion ankle fractures were treated by open reduction and internal fixation. Twenty-nine cases had only lateral malleolus fracture, 52 had bimalleolar fracture and 47 had trimalleolar fracture. A total of 122 patients were treated with a conventional lateral plate (98 one-third tubular plates and 24 locking-plates), and six patients were treated with an antiglide plate. Posterior malleolus fractures with defects bigger than 1/4 of the joint surface were reduced and fixed with compression screw of 3.5 mm through posterolateral approach. Their functional results were evaluated according to the Olerud and Molander system and the bone healing was evaluated by X-ray film.  RESULTS AND CONCLUSION: All patients were followed-up for 12-25 months. The fractures were healed in all cases. Five cases (4%) suffered from delayed wound union, including three patients treated with locking plates and two patients with one-third tubular plates. The clinical results were satisfactory, with the excellent and good ratio of ankle score being 91%. Thirty-one patients treated with lateral plates underwent implants removal after union, including 19 cases with tubular plates and 12 cases with locking plates, there was significant difference (P < 0.05). Cold-welding occurred in two cases (17%) treated with locking plates during the removal of implants. One case suffered from peroneal tendonitis after antiglide plate fixation. Exact reduction, stable internal fixation and active postoperative rehabilitation can help the joint recover to normal function in elderly patients with displaced supination-eversion ankle fractures. Related Articles | Metrics

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Short-segment transpedicular screw internal fixation combined with vertebroplasty of autologous granular bones in treatment of thoracolumbar burst fractures: A follow-up evaluation of 33 cases Liu Ping, Xu Hong-guang, Wang Hong, Yang Xiao-ming, Ding Guo-zheng 2010, 14 (26):  4911-4914.  doi: 10.3969/j.issn.1673-8225.2010.26.040 Abstract ( 387 )   PDF (335KB) ( 445 )   Save BACKGROUND: Short-segment transpedicular screw internal fixation is one of the important methods in treating thoracolumbar burst fracture. However, the formation of intravertebral void during vertebrae reduction and lost of structure integrality of anterior and middle columns lead to fixation failure or correction loss if no effective bone grafting.  OBJECTIVE: To study the methods and long term results of transpedicular screw internal fixation combined with vertebral plasty of pellet autos bones in treatment of thoracolumbar spine fracture. METHODS: Thirty-three patients with thoracolumbar spine fracture were treated with short-segmental transpedicalar screw internal fixation combined with vertebral plasty of pellet autos bones. X-ray examinations were done preoperatively. The change of compressed ratios of the anterior and posterior edges of vertebral body and the middle heights of the injured vertebra, as well as the improved Cobb angle were observed respectively. RESULTS AND CONCLUSION: The mean value of anterior compressed ratios, middle heights compressed ratios and Cobb angle were obviously decreased postoperatively than that of preoperatively (P < 0.05), which had no statistical significance compared with immediately after operation (P > 0.05). According to standard of American Spinal Cord Injury Association, the nerve function of 29 cases with incomplete spinal cord injuries reached grade 1 recovery after operation. Related complications were found in all patients. The results demonstrated that transpedicular screw internal fixation combined with vertebral plasty of pellet autos bones can restore the height and strength of vertebral body, improve the reduction effect of vertebral endplate, decrease correction loss, as well as elevate spinal stability. Related Articles | Metrics

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Three-dimensional finite element analysis of the zygapophyseal joints following artificial lumbar disc replacement Wang Hua, Xu Da-qi, Hu Jian-zhong, Li Kang-hua, Lin Zhang-yuan, Lei Guang-hua 2010, 14 (26):  4915-4919.  doi: 10.3969/j.issn.1673-8225.2010.26.041 Abstract ( 432 )   PDF (288KB) ( 378 )   Save BACKGROUND: With deepening of spinal biomechanics, artificial lumbar disc replacement is considered to be the optimal choice for treating degenerative lumbar disease. However, studies concerning biomechanics of artificial lumbar disc are insufficient. OBJECTIVE: To establish the three-dimensional (3-D) finite element model of artificial lumbar disc replacement and to explore the effects of artificial lumbar disc replacement on zygapophyseal joints using biomechanical analysis. METHODS: Based on normal 3-D finite element model of lumbar motion segment, L4-5 intervertebral disc, superior and inferior endplates were removed, and then, the model of SB-Charite Ⅲ disc prosthesis was added, which remained annular fibrosus and ligaments at L4-5 intervertebral space. Thus, 3-D finite element model of L4-5 segments artificial lumbar disc replacement was constructed. Biomechanical analysis of this model was processed under axial load, forward flexion, lateral bending or posterior extension moments. The stress data were contrasted with the normal 3-D finite element model of artificial disc replacement. RESULTS AND CONCLUSION: After artificial lumbar disc replacement, the data of biomechanical analysis indicated: ①There was no significant differences between the zygapophyseal joint and normal segment of stress under axial load (P > 0.01).      ②Compared with normal segment, the stress of anterior, posterior of upper and lower vertebral body and bilateral zygapophyseal joint had no obviously difference under forward flexion and posterior extension moments (P > 0.01). ③The stress differences between the both sides of upper and lower vertebral body and bilateral zygapophyseal joint were not significant under lateral bending moment (P > 0.01). Artificial lumbar disc replacement can keep the stress of motion segment at normal level, which can meet the needs of spinal functional reestablishment. Related Articles | Metrics

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Accuracy of tunnel-type template assisting mini-implant anchorage surgery based on multislice spiral computed tomography Chen Jing-yi, Shan Li-hua 2010, 14 (26):  4920-4923.  doi: 10.3969/j.issn.1673-8225.2010.26.042 Abstract ( 313 )   PDF (352KB) ( 400 )   Save BACKGROUND: Preplant diagnosis and rigorous implant strategy based on multislice spiral computed tomography (MSCT) imaging can improve success rate of mini-implants as anchorage. Effective application of imaging information in implant anchorage requires reliable tools and methods. OBJECTIVE: To investigate the accuracy of the radiographic and tunnel-type surgical templates assisting implant anchorage surgery and evaluate the clinical significance. METHODS: The transparent radiographic templates were made with occlusal rest to assist MSCT to scan two pigs’ skulls locatively. After designed the implant anchorage angles in MSCT images accurately, we made the tunnel-type surgical template by angle data. A total of 32 miniscrews were implanted by surgical template, and the two pigs skulls were rescanned by MSCT. After dissected the pig alveolar process, the MSCT preoperative planning angles, the MSCT postoperative measurement angles and the measurement angles of anatomic bone samples were analyzed statistically.  RESULT AND CONCLUSION: The 32 miniscrews were implanted successfully. They did not damage dental roots or surrounding important structures. Compared MSCT preoperative planning angles with MSCT postoperative measurement angles and anatomic bone samples measurement angles, there were no significant differences on axial sections or cross-sections and the r concordance correlations were very good. Results show that the radiographic and the tunnel-type surgical templates are accurate and reliable for operation and will help to improve the success rate of implant anchorage. Related Articles | Metrics

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Influence of body mass index on function outcome after total knee replacement Gao Hui 2010, 14 (26):  4924-4928.  doi: 10.3969/j.issn.1673-8225.2010.26.043 Abstract ( 266 )   PDF (329KB) ( 315 )   Save BACKGROUND: Some studies have considered the influence of body mass index (BMI) on the function following total knee replacement (TKR), but the cases were few and follow-up time is short in most of them. OBJECTIVE: To analyze the function outcome influenced by BMI after TKR. METHODS: A total of 320 osteoarthritis patients who were admitted in Department of Bone and Joint at Peking University People's Hospital, were involved in this study. They all received primary knee joint patellar resurfacing, including both knees replacement in 200 case of 520 knees, left 219 and right 301. The involved 320 patients underwent primary TKR performed by a single surgeon with the same type of prosthesis (Scorpio posterior stable prosthesis). The patients were divided into four groups based on obesity (overweight group, BMI 25.1-27.0 kg/m2; obese group, BMI 27.1-30.0 kg/m2; morbidly obese group, BMI > 30 kg/m2; control group, BMI < 25 kg/m2). According to the Hospital for Special Surgery (HSS) rating scale, their knee score and functional scores were recorded before replacement and at follow-ups, as well as maximal range of flexion and extension, complications. Preoperative and postoperative assessment was based on the HSS score.  RESULTS AND CONCLUSION: A total of 320 patients received clinical recheck at 28.3 months (range 12-46 months). Compared with control group, patients in overweight, obese and morbidly obese groups had lower preoperative functional score (P < 0.05), but knee scores were not significantly different for any patient group. The postoperative mean HSS score of all the groups rose significantly at the last follow-up. These differences were not statistically significant among groups (P > 0.05). The rate of perioperative complications was significantly higher in the obese and morbidly obese patients (P < 0.05). Of the 181 knees in obese and morbidly obese patients, 14 knees (9.2%) had a wound complication, 1 knee (0.5%) had an infection, and 2 knees (1.3%) had an avulsion of the medial collateral ligament. The infected case developed within ten weeks after the operation, and was associated with a wound complication. Among 266 knees in the overweight patients, 6 knees (2.3%) had a wound complication. There was 1 knee (1%) of the 81 knees in the control group had a wound complication. No death or pulmonary embolism cases were observed in perioperative period. It is suggested that BMI has no obvious influence on the functional outcome following TKR in the short-term. Related Articles | Metrics

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Molecular biological mechanism of osteolysis induced by titanium wear particles of artificial joint Wang Gang, Cai Qing, Liu Shi-qing 2010, 14 (26):  4929-4932.  doi: 10.3969/j.issn.1673-8225.2010.26.044 Abstract ( 370 )   PDF (485KB) ( 412 )   Save BACKGROUND: Under wear particles stimulation, mononuclear macrophages, fibroblasts, and osteoblasts can produce a large amount of inflammatory factors, leading to periprosthetic osteolysis. But the precise mechanisms remain unclear. OBJECTIVE: To analyze the molecular biological mechanism underlying osteolysis induced by titanium wear particles . METHODS: Macrophages were separately cultured with cleaned titanium particles, lipoplysaccharide (LPS)-bound titanium particles, and LPS solution. At 4, 8, 16, and 32 hours, mRNA expression levels of receptor activator of nuclear factor kappa B (RANK) and osteoprotegerin (OPG) were detected by reverse transcription-polymerase chain reaction and nuclear factor kappa B (NF-кB) binding activity was analyzed using electrophoretic mobility shift assay (EMSA). RESULTS AND CONCLUSION: Cleaned titanium particles stimulation induced an unbalanced ratio of RANK mRNA to OPG mRNA. Over-expressed RANK bound to RANK ligand and promoted osteolysis. No RANK mRNA expression was detected in the LPS group, but OPG mRNA expression was transiently increased at 4 hours. NF-κB/inflammatory cytokine, rather than RANK/OPG, is the main signal pathway for LPS to induce osteolysis. After LPS binding to titanium particles, these two signal mechanisms, RANK/OPG and NF-κB/inflammatory cytokine, have synergistic effects during artificial joint loosening.   Related Articles | Metrics

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Controlled hypotension combined with autotransfusion in patients with idiopathic scoliosis Yin Xiang, Wang Ai-min, Sun Hong-zhen, Du Quan-yin, Wang Zi-ming, Wang Yu 2010, 14 (26):  4933-4936.  doi: 10.3969/j.issn.1673-8225.2010.26.045 Abstract ( 384 )   PDF (269KB) ( 300 )   Save BACKGROUND: Idiopathic scoliosis is a common spinal deformity in teenagers, which is managed mainly by orthomorphia. However, due to great trauma, long operative duration and large blood loss, a great amount of blood transfusion is needed during the surgery. Allogeneic blood transfusion should be reduced in order to release blood insufficient, decline blood transfusion expense, as well as avoid transfusion diseases. OBJECTIVE: To investigate the value of controlled hypotension combined with autotransfusion in idiopathic scoliosis orthomorphia. METHODS: Intraoperative controlled hypotension was performed during posterior orthomorphia surgery on all the 46 cases of idiopathic scoliosis, 17 cases in which were served as the control group, who underwent allogeneic blood transfusion without autotransfusion, while the other 29 cases were served as the experimental group, who underwent autotransfusion that including reinfusion of preoperative deposited autologous blood and intra-operative salvaged autologous blood. The blood loss volume and transfusion status in two groups were observed. RESULTS AND CONCLUSION: Blood loss volume in the control group was 400-1 000 (867±161) mL, and that in the experimental group was 350-1400 (842±376) mL, There was no marked difference between the two groups (P > 0.05). The volume of allogeneic blood transfusion in the control group was 500-1 800 (845±332) mL, which was greater than that in the experimental group [0-1 300(423±237) mL] (P < 0.01). The results suggested that controlled hypotension reduces intraoperative bleeding, and postoperative autotransfusion minimizes the need of allogeneic blood transfusion. Related Articles | Metrics

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Effect of spinal stabilization training on the vertebral osteoporotic compression fracture: An individualized program Yang Lin, Yang Yong-hong, He Hong-chen, Yu Peng-ming, He Cheng-qi 2010, 14 (26):  4937-4940.  doi: 10.3969/j.issn.1673-8225.2010.26.046 Abstract ( 430 )   PDF (216KB) ( 437 )   Save BACKGROUND: Surgery is a main method to reconstruct the stability of spine after compression fracture. But the reconstruction of spinal stability for patients undergoing conventional therapy remains unclear. OBJECTIVE: To explore whether spinal stability training is effective on improving pain and motor function of patients with vertebral osteoporotic fractures. METHODS: Patients with vertebral osteoporotic fractures were divided into two groups. The study group was treated with conventional treatments and individualized spinal stabilization training, while the control group received conventional treatments alone. All the subjects were evaluated before and after treatment by numeric pain rating scale (NPRS), 3-meter timed up and go (TUG) and Oswestry functional limitation index (OFLI). The results were compared between the two groups. RESULTS AND CONCLUSION: A total of 27 patients were included, including 16 patients in the study group and 11 in the control group. After 4-week treatment, TUG and OFLI in the study group decreased significantly compared with the control group (P < 0.05). But there was no statistical significance between the two groups in the level of NPRS and the amount of changes (P > 0.05). Symptoms and function of both groups were improved after treatments. Individualized spinal stability training is effective to restore the motor function and may be helpful for reducing pain for patients with vertebral osteoporotic fractures combined with conventional treatments. Related Articles | Metrics